This following information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
As a new mom, you may find yourself facing many decisions from a new perspective. The birth control choice that was right for you before pregnancy may not be the right choice after having a baby, especially if you are nursing. For answers about birth control after baby, including when to start and what options are best while breastfeeding, I considered both my doctor's advice and the experiences shared by Circle of Moms members.
When to Start
Typically, doctors advise holding off on intercourse until you have a checkup with your ob-gyn about six weeks after giving birth. At this visit, your doctor will evaluate how you are healing and whether it is safe to begin having sex again. It's important to give your body a break, and as Circle of Moms member Kristin G. says: "Now is a really good time to talk to your OB/Gyn about the options available and do a little research on your own. Also, talk with your husband about the size of family you think you might want and how far apart you might want them to be... You need to let yourself heal. You've got time to make these choices."
It is true that some women heal quickly and feel ready for sex as soon as two to four weeks after delivery. Other moms say it took months before they felt ready to have intercourse again, especially after a difficult vaginal birth or C-section. One mom named Phara delivered via C-section and felt she needed some extra time: "Even though I had a C-section, we waited three months. I wanted to give my body a rest after all it had been through!"
One thing is for sure: whether you wait three weeks or three months, it is possible to get pregnant after giving birth. That's why it's important to talk to your partner about using protection if you don't want another baby right away.
Birth Control and Breastfeeding
If you are nursing your newborn, there are some special considerations when it comes to choosing the right birth control method. You want a proven, effective way to prevent pregnancy without decreasing your milk supply or causing your baby to ingest anything harmful. Your main choices fall into two categories: nonhormonal birth control or hormonal birth control.
Birth control methods that do not use hormones are considered the safest for nursing moms. The most commonly used nonhormonal birth control is the condom. As Michelle K. sums it up, "Condoms are good, cheap, and [have fewer] side effects." Another member, Jane M., recommends condoms because you can use them right away and they allow your partner to "pick up the slack," giving you more time to make decisions with your doctor about long-acting methods.
- IUD — ParaGard
A long-acting, nonhormonal birth control method that is gaining popularity in the US is the ParaGard IUD (intrauterine device). Unlike the other IUD, which is known as Mirena, ParaGard uses no hormones, which is one of the reasons Circle of Moms user Margaret K. likes this option: "I have Paragard IUD. Works fabulously. Longer and heavier each month but no cramping which is a plus for me. It also lasts for 10-12 years." An IUD can usually be inserted by your doctor during an office visit. The most common ParaGard side effect indicated by women in the Circle of Moms communities is heavier periods. Read more about the ParaGard IUD on the manufacturer's website, ParaGard.com.
- IUD — Mirena
There are birth control methods that use low doses of hormones and are considered safe while breastfeeding. As mentioned above, another long-acting IUD called Mirena has gained popularity in recent years. Mirena is similar to ParaGard, except that it releases low doses of hormones and lasts for up to five years. There is quite a lot of chatter about Mirena in the Circle of Moms communities. You will find members who share very positive experiences, as well as moms who had complications and problems with this method. Samantha M. had nothing but great things to say about her decision to get Mirena: "I got it six weeks after my son was born (he is two now), and I have had no problems with it at all! I would recommend [it] because it is good for five years. I also haven't had a cycle in two years, which is another huge benefit!" A community on Circle of Moms called "Mirena Moms" is dedicated to moms who use or have used the Mirena IUD and have had problems as a result. If you are considering Mirena, this community discusses side effects in detail. Read more about the Mirena IUD on the manufacturer's website, Mirena.com.
Another very popular hormonal birth control for nursing mothers is the "minipill." There are several different manufacturers' names for birth control pills that only contain the hormone progestin. Megan B. says her doctor prescribed a minipill called Micronor: "It is low dose, that way no more hormones than necessary get into the breast milk." Alison O. also likes the minipill because "It's not supposed to mess with your milk supply". If you have used birth control pills in the past, the risks and side effects are about the same with the minipill. According to WebMD, minipills are about 95 percent effective, which is slightly less effective than standard birth control pills.
- Injectables and Implants
I put these in the same category because they use virtually the same hormone and both are inserted in the arm — the only difference is the delivery method. Depo-Provera is a shot that you get in your arm every few months. It is highly effective at preventing pregnancy and safe for nursing moms, however, many doctors have moved away from Depo because of evidence that it causes significant bone loss with prolonged use. (See: "Birth Control and Depo-Provera" at WebMD.) Some women in the Circle of Moms communities who have used Depo over the years also reported side effects including weight gain, loss of libido, mood swings, and irregular bleeding. Implanon is a similar form of birth control in which a matchstick-sized rod is placed under the skin of your arm. It remains in place and is effective for up to three years. Women who share their Implanon experiences on Circle of Moms report similar side effects to those listed above for Depo-Provera. Racheal S. used this method in the years before having her twins and again, after: "I loved it although it makes your period irregular sometimes... It was just hassle-free and a lot cheaper than the pill." Evelyn M. also recommends Implanon: "I've had mine in [for] 1.5 years. Very good, high contraceptive protection. Everybody is different in how they react/get side effects. I personally don't have many and found it good. I don't get periods anymore!" Read more about Implanon on the manufacturer's website, Implanon-usa.com.
Is Breastfeeding Birth Control?
There is a great deal of debate over whether or not nursing your baby is birth control in itself. It is a fact that breastfeeding can delay ovulation, and there is a practice known as lactational amenorrhea that women have used for centuries to prevent pregnancy. Circle of Moms member Sara J. outlines the method very well: "You cannot supplement at all with anything. You must feed on demand, day and night. Ecological breastfeeding works best to prevent the return of fertility. Moms that practice ecological breastfeeding co-sleep, feed on demand day and night, no pacifiers or bottles, and usually delay the introduction of solids."
Even if you are able to adhere to these strict methods and delay ovulation, you will begin to ovulate again at some point in time. Skipping a feeding here and there, along with your baby's natural progression to solids, will put an end to the birth control aspect of breastfeeding. Will you know when that happens? As Melissa J. says, "the reason it is not reliable birth control is because you never know when you will start ovulating again."
Which birth control method has worked best for you since becoming a mom?
This article is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.